Charmaine Payne was like any other 24 year-old woman; she was the healthy mother to an energetic three-year-old boy and worked hard as a scheduler/ secretary for a busy orthopedic practice. One chilly day in February, while picking up her son, Grayson, from daycare, her world was turned upside down."I was sitting in the car talking to my husband on the phone, when all of a sudden he couldn't understand what I was saying," said Charmaine.
According to her husband's description, Charmaine began slurring her speech and complaining of tongue pain. She also noted that she felt as if she could notcontrol her right arm, which seemed to be drawing up involuntarily. Her parents were contacted and soon arrived in order to drive Charmaine and her son home. When her husband, Michael, who works as an EMT, arrived home from work, he took herto the nearest emergency room for evaluation. As she was being evaluated in the ER, she began having "full blown tonic-clonic seizures." "I don't remember what was happening to me," said Charmaine. Michael witnessed the events unfold. A CT of the head was obtained, which revealed a left frontal mass.
Charmine and her family requested a transfer to Jim Robinson, M.D., who specializes in brain tumor surgery and treatment at Piedmont Hospital, and she was brought to Piedmont that night. Charmaine's condition was stabilized with anticonvulsant medication, and further diagnostic tests were obtained. Dr. Robinson informed Charmaine and her family that she had what appeared to be a benign tumor of the brain that was on the border of her primary motor cortex (the fold in the left side of the brain controlling all the movement on the right side of her body). The tumor was causing electrical irritability in the brain tissue adjacent to the tumor, resulting in focal seizures affecting her speech and right arm. The tumor could potentially be removed, but would require a delicate operation, best performed with Charmaine awake.
Charmaine was released from the hospital once her seizures seemed to be well controlled. Dr. Robinson referred her to Larry Seiden, M.D., a neurologist at Peachtree Neurology specializing in seizure disorders. Despite being on medication, Charmaine experienced ongoing intermittent episodes of stuttering speech, forgetfulness and tingling in her right arm. The seizures proved to be difficult to manage, with ongoing episodes despite increasing amounts of medication. Surgery was planned with the hope of eliminating the seizures and to remove tumor tissue, thereby reducing the risk of the tumor becoming cancerous over time. Dr. Robinson and Dr. Seiden would work together during surgery to provide the best opportunity to remove the tumor, preserve Charmaine's right body and speech function, and eliminate the seizures.
On May 10, Charmaine arrived at Piedmont Hospital for the surgery. She met Scott Solomon, M.D., a member of Piedmont's neuroanesthesiology team, who would manage the drugs that would allow Charmaine to remain awake, but comfortable, during her brain surgery. She received a high resolution MRI that would be used for "navigation" in the operating room. "It's like GPS for brain surgery," explains Dr. Robinson. The technology allows the surgeon to use instruments in surgery that are tracked by a computer system showing the position on the surface or inside the head to an accuracy of 1 millimeter. This aids in minimizing the opening of the scalp and skull to the extent necessary, and also aids in identification of the margins of the tumor itself. Charmaine remained comfortable while Dr. Robinson exposed the tumor.
A procedure called brain-mapping was then undertaken, during which motor and speech areas on the surface of the brain are identified. Once the tumor was removed, an electroencephalogram (EEG)–a test that measures and records the electrical activity of the brain–was performed directly on the brain surface, which showed no evidence of electrical irritability. This was a good indicator that the seizure disorder had been successfully treated. Charmaine did very well following her surgery and was allowed to return home two days later. She returned to work several weeks later and is now functioning normally.
Charmaine was recently seen for her six-week follow-up appointment with Dr. Robinson, and was seizure-free. Charmaine and her family are happy to have this behind her. She looks forward to moving back to life as normal with her family. Dr. Robinson is pleased with her postoperative neurologic function and her MRI, which showed near complete removal of tumor without any complication.